The Candidate is an Assistant Professor who plans a career as a patient-oriented independent clinical investigator and epidemiologist focused on health disparities and advanced lung diseases such as pulmonary fibrosis. His training plan includes mentored didactic and practical experience in (1) health disparities research, (2) clinical trials, and (3) advanced epidemiology and biostatistical training within the Division of Pulmonary, Allergy, and Critical Care Medicine of Columbia University, the NCMHD-funded Columbia Center for the Health of Urban Minorities, and Columbia University's Mailman School of Public Health. The proposed research plan will be carried out in Columbia's Clinical and Translational Science Award (CTSA)-funded Irving Center for Clinical and Translational Research. Study subjects will be recruited from the New York Presbyterian Hospital Lung Transplant Program and the Columbia Center for Interstitial Lung Disease, both located at Columbia University's College of Physicians and Surgeons. The Candidate proposes to conduct a prospective cohort study of patients with idiopathic pulmonary fibrosis (IPF), a devastating disease with a median survival of only 3 years. His preliminary data suggest that non-Hispanic black and Hispanic patients with IPF have worse lung function, lower exercise capacity, and a higher mortality rate than non-Hispanic white patients both at Columbia and in a nationwide study at 94 transplant centers. The proposed study will examine whether delayed referral for subspecialist care and more severely impaired exercise capacity among minorities contribute to survival disparities. Health care access factors at multiple levels will be explored as potential contributors to these disparities. The proposal will prepare the Candidate to design and perform randomized trials of specific interventions aimed at ameliorating racial and ethnic disparities in IPF and other advanced lung diseases. Relevance: The NIH Roadmap and the Institute of Medicine have made research that investigates the underlying causes of health disparities a national public health priority. We propose to identify factors that explain survival disparities in a fatal lung disease called idiopathic pulmonary fibrosis. Results of this study will be used to design clinical trials aimed at reducing these disparities.